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Invictus Employment Application

This application has been optimized for any position with Invictus International corporate and all of its divisions.

This order form is provided in a secure environment and to help protect against fraud your current IP address (38.107.179.241) is being logged.

Personal Information

Last Name:	MI	First Name
Present Address:	City	State	Zip Code
Permanent Address:	City	State	Zip Code

Home Phone:		Contact Phone
Any Previous Names		Email Address

Availability

Best time to contact you		Date available for work
Would you consider working:		Weekends & Holidays Rotating Shifts On Call Any Shift
Shift Availability:		Days Evenings Nights
Check all you would consider working:		Full Time/Reg Full Time/Temp Part Time/Reg Part Time/Temp

Position

Position Applied for		Salary Desired

How did you learn about this position?(Newspaper, Internet, Friend, If other-please list)

Education / Skills

School	Name of School	Course of Study	Last Year Completed	Did you graduate?	List Diploma or Degree
High				Yes No
College				Yes No
College				Yes No

Other Business College or Special Courses: (Include Special Military Training, Post Graduate and Nursing)
Area(s) of Specialization or major interest
List office skills including computer/software experience
Word processing(Approx. WPM)
List healthcare, business, or industrial equipment operated

Briefly describe duties and skills acquired through military or volunteer service:(include dates)

Professional Certifications or Professional License

Currently Certified Eligible for Certification	Type:	Currently Licensed Currently Registered Eligible for License Eligible for Registration	Type:
	State:		NO:
	Date:		State:
			Date:

Currently Certified Eligible for Certification	Type:	Currently Licensed Currently Registered Eligible for License Eligible for Registration	Type:
	State:		NO:
	Date:		State:
			Date:

Work Experience

Job Title:	From		To
Employer Name:	Supervisor Name:
Address:	Phone:
Salary:	May we contact your Employer?		Yes No
Duties:		Reason for Leaving:

Job Title:	From		To
Employer Name:	Supervisor Name:
Address:	Phone:
Salary:	May we contact your Employer?		Yes No
Duties:		Reason for Leaving:

Job Title:	From		To
Employer Name:	Supervisor Name:
Address:	Phone:
Salary:	May we contact your Employer?		Yes No
Duties:		Reason for Leaving:

Job Title:	From		To
Employer Name:	Supervisor Name:
Address:	Phone:
Salary:	May we contact your Employer?		Yes No
Duties:		Reason for Leaving:

References

Name and Relationship		Title
Company Name and Address		Telephone

Name and Relationship		Title
Company Name and Address		Telephone

Name and Relationship		Title
Company Name and Address		Telephone